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Archives of dermatological research
Apr, 2021;313 (3): 155-162.

Outpatient healthcare utilization and prescribing patterns for herpes zoster in United States adults.

Partik Singh, Nanette B Silverberg, Jonathan I Silverberg
Author Information
  1. Partik Singh: Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA.
  2. Nanette B Silverberg: Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, USA.
  3. Jonathan I Silverberg: Department of Dermatology, The George Washington University School of Medicine and Health Sciences, Suite 2B-425, 2150 Pennsylvania Avenue, Washington, DC, 20037, USA. JonathanISilverberg@gmail.com.
PMID: 32390077 DOI: 10.1007/s00403-020-02085-y

Abstract

Little is known about health resource utilization and treatment patterns for herpes zoster (HZV) after the introduction of HZV virus vaccination. The objective of this study is to characterize trends in HZV utilization, racial disparities, and treatment patterns in the United States. Data from the 1993-2015 National Ambulatory Medical Care Survey were analyzed, including 15,400,000 weighted primary acute HZV visits in adults. Overall, the weighted frequency (95% confidence interval) of HZV visits increased from 1993-1998 to 2007-2015 (1,269,815 [565,455-1,974,175]-8,017,911 [6,424,491-9,611,331], P = 0.0001). HZV visits were associated with African-American (38.8% [35.8-41.7%] vs. 8.2% [7.4-9.0%]) and Hispanic race/ethnicity (12.6% [6.6-18.5%] vs. 8.0% [7.3-8.5%]), public insurance (42.7% [36.6-49.2%] vs. 33.7% [32.2-35.2%]) in comparison with all other visits. Oral antiviral agents were prescribed in 64.3% (58.1-70.1%) of HZV visits. HZV visits were associated with higher rates of opioid prescriptions compared to all other visits (18.4% [14.0-23.9%] vs. 6.1% [5.6-6.6%], P < 0.0001). The limitation is no data on HZV severity. HZV visits increased over time, even after introduction of HZV vaccines. There were significant racial/ethnic and healthcare disparities of, and high rates of opiate and corticosteroid prescriptions at HZV visits. Future efforts are needed to address these practice gaps, and encourage vaccination and evidence-based prescribing in HZV.

Keywords

Herpes zoster virus Shingles Utilization

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Grants

  1. CDA/Dermatology Foundation

MeSH Term

Administration, Oral
Adult
Black or African American
Aged
Ambulatory Care
Analgesics, Opioid
Antiviral Agents
Cross-Sectional Studies
Drug Prescriptions
Drug Therapy, Combination
Female
Glucocorticoids
Healthcare Disparities
Herpes Zoster
Hispanic or Latino
Humans
Male
Middle Aged
Neuralgia, Postherpetic
Patient Acceptance of Health Care
Practice Patterns, Physicians'
Professional Practice Gaps
Sex Distribution
United States
White People

Chemicals

Analgesics, Opioid
Antiviral Agents
Glucocorticoids
Journal Article

Word Cloud

Created with Highcharts 10.0.0HZVvisitsvsutilizationpatternszostertreatmentherpesintroductionvirusvaccinationdisparitiesUnitedStatesweightedadultsincreased[60001associated8[75%]7%2%]1%ratesprescriptionshealthcareprescribingLittleknownhealthresourceobjectivestudycharacterizetrendsracialData1993-2015NationalAmbulatoryMedicalCareSurveyanalyzedincluding15400000primaryacuteOverallfrequency95%confidenceinterval1993-19982007-20151269815[565455-1974175]-8017911424491-9611331]P = 0African-American388%[358-417%]2%4-90%]Hispanicrace/ethnicity126%6-180%3-8publicinsurance42[366-4933[322-35comparisonOralantiviralagentsprescribed643%581-70higheropioidcompared184%[140-239%]6[56-66%]P < 0limitationdataseveritytimeevenvaccinessignificantracial/ethnichighopiatecorticosteroidFutureeffortsneededaddresspracticegapsencourageevidence-basedOutpatientHerpesShinglesUtilization

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